Twenty consecutive patients with severe mitral regurgitation secondary to end-stage dilated cardiomyopathy underwent mitral annuloplasty for refractory symptoms of heart failure, On follow-up 18 +/- 4 months after annuloplasty, 14 patients (70%) were alive, all 14 noted symptomatic improvement, and quantitative echocardiographic/Doppler demonstrated decreases in left ventricular volume and sphericity accompanied by increases In ejection fraction and forward cardiac output.